Onemanda Preisinger is nervous about her child’s impending 13th birthday celebration. It’s not due to the usual causes related to a house full of loud adolescent children, but since it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not how I look,’” says the thirty-year-old real estate agent from Southern Florida.
Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”
According to cosmetic specialists, Preisinger is among a growing number of people electing to have a facelift in their 20s and 30s – significantly before a ten years prior to most doctors’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals choosing it as a lifestyle choice.”
A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Human faces are built a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that is what ages us; that’s what becomes lax and drags the skin downward with it.”
You risk operating on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to pursue
Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and leads to looseness in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a new kind of customer towards this major operation. Reports show an 8% increase in facelifts over the last year in the UK; while a study found that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.
“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.
While a more traditional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing doctors to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.
Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”
Whether injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that in a sense, the face becomes somewhat waterlogged because its capacity to remove bodily fluid has been diminished.” Although research into the topic is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using fillers in a patient because of the dangers they pose. “A lot of surgeons avoid talk about this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.
For Preisinger, once she started using injectables, she believed she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.
Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facial lift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|
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